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Apnea and IBS - Ron Poelstra - 12-22-2021

Hi moderators,

How would we find out how many of the board members that suffer from CA or Complex apnea, also have some form of IBS?  Since it seems that CA and IBS are both a brain to nervous system issue, it would be interesting to find out...  What do you think?


RE: Apnea and IBS - Geer1 - 12-22-2021

CA is usually interpreted as central apnea (which I believe what you are referring to). Complex apnea is actually a mixture of central and obstructive, it usually starts as a central apnea during which an obstruction forms during the lack of breathing.

I don't think you can draw any significant conclusions between central apnea and IBS. The main reason being that IBS is very poorly defined and understood and therefore many functional digestive issues often get classified as IBS many (I personally would argue most) cases of IBS are not central nervous system based. I think true central nervous system based IBS like say what occurs in Parkinson's patients is actually quite rare.


RE: Apnea and IBS - Ron Poelstra - 12-22-2021

I don't know about your conclusions, a quick search on the Internet shows more than a few studies showing possible links.  Both with brain to nervous system links.  Although I need to admit that most studies show the link from IBS to Central, saying that IBS may indeed cause sleep disturbances.  Studies suggest that IBS is possibly a brain to gastro connection and Central Apnea also has a brain to pulmonary connection.  Since both are usually idiopathic, more research would indeed be interesting.


RE: Apnea and IBS - Geer1 - 12-23-2021

Key word, possible links.

I was looked at, symptoms listened to and "diagnosed" with IBS. Removing dairy and gluten from my diet and treating SIBO resulted in a significant reduction of my "IBS". Maybe I still have minor centrally driven IBS but the majority of my digestive issues were resolved by diet changes and antibacterial treatments.

The problem with IBS is that it is a loosely defined syndrome. They have pretty much labelled all functional digestive issues as IBS. Imo that is why there are no studies that are able to determine the cause of IBS, it is too loosely defined and therefore encompasses multiple issues that will never respond to treatments or tests the same way because they are not even closely related. 

Here is a meta analysis stating ~35% of patients with IBS have tested positive SIBO (the question is which is causing which? in those cases, many people with digestive issues improve if not totally resolve their symptoms by treating SIBO).

https://pubmed.ncbi.nlm.nih.gov/31913194/

And here is a brief study with some mentions of food intolerance and localize immune responses potentially being the cause for "IBS" in some patients.

https://www.sciencedaily.com/releases/2021/01/210117132238.htm

I now know multiple people that have "treated" their "IBS" by doing food elimination diets and removing troublesome foods.

The reality is that modern medicine still knows very very little about the functional side of digestion and until they figure out more of the details they will continue to fail at diagnosing and treating functional digestive issues.


RE: Apnea and IBS - Ron Poelstra - 12-26-2021

I agree with what you have stated.  I have had issues with digestion since about 12 years of age.  Just seems to have gotten worse with age.  I thought it interesting when my Gastro doc told me of recent studies that suggest a nervous system link.  Since I have IBS and Complex Apnea, I thought it would be an interesting question.


RE: Apnea and IBS - Sleeprider - 12-26-2021

You are welcome to start a poll. The poll options could be:
I have central apnea without irritable bowel syndrome (IBS)
I have central apnea with IBS
I do not have central apnea but have IBS
I do not have central apnea or IBS

This would give you some idea of whether or not there is a connection to these issues for members on Apnea Board and give you a rough idea of individuals with and without central apnea. You may want to define central or complex apnea as being a CAI greater than 3 or 5 events per hour prior to treatment, with or without OSA.


RE: Apnea and IBS - Geer1 - 12-26-2021

There is a nervous system link but I personally think it is correlation not causation for a number of people. Our digestive system controls and affects all of our systems including the nervous system and I think a lot of people have nervous system symptoms are caused by a dysfunctional gut. The reality is modern medicine probably understands the brain more than the gut and understands both poorly, they need to learn a lot more before they start understanding what is actually causing what.

For example I was having what I am fairly sure was small fiber neuropathy, non length dependent paresthesia (little nerve zaps throughout body) and had worsening hand tremors. The removal of dairy from my diet and/or SIBO treatments improved both of these issues to the point they are no longer bothersome. Other digestive issues like celiac, parasites etc cause obvious nervous system issues.

There are also some interesting studies showing relation and potential causation of dysfunctional digestive systems and nervous system issues like Parkinson's. This is something I have interest in and have been following for a few years now as my Grandmother has Parkinson's and I have almost every pre Parkinson's symptom and have had some of them for over a decade (was diagnosed with essential tremors in University). I have found it very interesting that most if not all of these symptoms have improved with my treatment of digestive symptoms and I am not the only one. There are lots people that have improved autoimmune disease etc with dietary changes and it actually blows my mind how slow modern medicine has been to embrace some things like elimination diets in a lot of these diseases.

https://www.nature.com/articles/s41531-021-00156-z


RE: Apnea and IBS - Geer1 - 12-27-2021

Just saw this elsewhere and figured it was relevant here. Neurological side effects of both celiac and non celiac gluten sensitivity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641836/


RE: Apnea and IBS - Ron Poelstra - 12-27-2021

Looks like interesting reading.  Thankyou


RE: Apnea and IBS - Helena - 01-01-2022

This paper on gluten ataxia might be of interest.

https://pubmed.ncbi.nlm.nih.gov/25925933/

Here is the abstract (I cannot access the whole paper.):

"Abstract

The term gluten-related disorders (GRD) refers to a spectrum of diverse clinical manifestations triggered by the ingestion of gluten in genetically susceptible individuals. They include both intestinal and extraintestinal manifestations. Gluten ataxia (GA) is one of the commonest neurological manifestations of GRD. It was originally defined as otherwise idiopathic sporadic ataxia in the presence of circulating antigliadin antibodies of IgA and/or IgG type. Newer more specific serological markers have been identified but are not as yet readily available. GA has a prevalence of 15% amongst all ataxias and 40% of all idiopathic sporadic ataxias. It usually presents with gait and lower limb ataxia. It is of insidious onset with a mean age at onset of 53 years. Up to 40% of patients have evidence of enteropathy on duodenal biopsy. Gastrointestinal symptoms are seldom prominent and are not a reliable indicator for the presence of enteropathy. Furthermore, the presence of enteropathy does not influence the response to a gluten-free diet. Most patients will stabilise or improve with strict adherence to gluten-free diet depending on the duration of the ataxia prior to the treatment. Up to 60% of patients with GA have evidence of cerebellar atrophy on MR imaging, but all patients have spectroscopic abnormalities primarily affecting the vermis. Recent evidence suggests that patients with newly diagnosed coeliac disease presenting to the gastroenterologists have abnormal MR spectroscopy at presentation associated with clinical evidence of subtle cerebellar dysfunction. The advantage of early diagnosis and treatment (mean age 42 years in patients presenting with gastrointestinal symptoms vs. 53 years in patients presenting with ataxia) may protect the first group from the development and/or progression of neurological dysfunction."


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(ETA: I do not have Central Apnea.)

I have IBS and avoid many things, including FODMAPs (such as stone fruits and sugar alcohols), various gums, such as guar gum, and have found elimination diets most helpful. I live on a low carb version, sans gluten, of the Royal Prince Albert Hospital Elimination diet, aka the FailSafe diet.

It means avoiding salicylates, glutamates, amines, etc.

Here is some info on it, in case it is of use to someone:

http://www.failsafediet.com/

Also, if I stay low-fiber, that helps me a great deal. Avoiding cruciferous vegetables helps me, too. The list of what I avoid is long.

That leaves me with unprocessed grass-fed meats, egg yolks, gelatin, goat's milk and yoghurt, blanched almond meal, occasional green beans or sweet potatoes, asparagus tips, peeled pears, chives, salt, home-rendered tallow, butter, rennet, vanilla, and a few secondary foods when I am doing well, such as sparkling mineral water, whole leaf stevia extract, and black tea.

If I go off the plan too much, there are problems.

I also do better within strict parameters of amounts of protein, fat, and carbs.

Too much protein causes (for me) agitation and an irritableness; too little means feeling weak, tired, and "weepy".

Too many carbs causes (for me) carb "hangover" and respiratory difficulty, and susceptibilty, and triggers a false appetite, and means weight gain due to increased insulin production. Too few, under ca. 25 per day, means an odd fatigue from my body working too hard. Perhaps my body struggles with gluconeogenesis....

Too much fat means my systems feel overloaded and I feel slightly ill and lethargic. Too little fat means hunger, and feeling like the tin man in "The Wizard of Oz" who needs oil put in his hinges.

Just enough protein, ca. 50-65g/day, with fat grams at ca. 2-2.5x the protein, and carbs at .5-.8 the protein grams, keeps things humming along. (I got those ratios from Dr. Jan Kwasniewski's "The Optimal Diet".) I have lived on them for many years. It takes gumption to stay on plan, but I feel much better when I keep those parameters.

It is a complex puzzle. Smile


Best wishes to all with intestinal challenges.